TY - JOUR T1 - Clinical relevance of mixed respiratory viral infections in adults with influenza A H1N1 JF - European Respiratory Journal JO - Eur Respir J SP - 739 LP - 742 DO - 10.1183/09031936.00168610 VL - 38 IS - 3 AU - M.A. Marcos AU - S. Ramón AU - A. Antón AU - E. Martinez AU - A. Vilella AU - V. Olivé AU - C. Cillóniz AU - A. Moreno AU - A. Torres AU - T. Pumarola Y1 - 2011/09/01 UR - http://erj.ersjournals.com/content/38/3/739.abstract N2 - To the Editors:Throughout the pandemic circulation of the 2009 influenza A H1N1 virus (A/H1N1p), concomitant detection of other respiratory viruses in the same patient was reported [1, 2], but their clinical relevance remains unknown. Mixed respiratory viral infections in adults have scarcely been studied. The aim of this study was to assess both the incidence of multiple viral respiratory infections and their clinical significance in adult patients with confirmed A/H1N1p.From October 1 to November 30, 2009, nasopharyngeal and oropharyngeal swabs were obtained from consecutive adults (>18 yrs of age) presenting with acute respiratory illness to the emergency department of Hospital Clinic (Barcelona, Spain). Specimens were placed in a tube containing viral transport medium (VTM) and were immediately sent to and processed at the microbiology laboratory for virological confirmation. Total nucleic acids were extracted from 200 μL of fresh specimen and eluted in 25 μL of RNase-free elution buffer using NucliSense easyMAG (BioMérieux, Marcy l’Etoile, France) according to the manufacturer’s instructions. The presence of A/H1N1p was confirmed by two specific one-step, multiplex, real-time RT-PCRs for influenza virus typing (A or B) and subtyping (H1, H3 or H5) as previously described [3, 4]. Laboratory results for A/H1N1p were provided to clinicians in <24 h. In those patients diagnosed with pneumonia, regular sampling for microbiological diagnosis was also performed as previously described [5].For the purpose of the study, samples with confirmed A/H1N1p were retrospectively assessed by multiplex PCR using the xTAG® RVP FAST Assay (Luminex–Abbott Molecular, Wiesbaden, Germany) according … ER -